Epinephrine Use in Endoscopic Ear Surgery: Quantitative Safety Assessment.

Alicandri-Ciufelli, Matteo; Molinari, Giulia; Beckmann, Sven; Caversaccio, Marco; Presutti, Livio; Anschütz, Lukas Peter (2020). Epinephrine Use in Endoscopic Ear Surgery: Quantitative Safety Assessment. ORL, 82(1), pp. 1-7. Karger 10.1159/000503725

Full text not available from this repository. (Request a copy)

INTRODUCTION The management of bleeding in exclusive endoscopic ear surgery (EES) is largely dependent on epinephrine use. However, to date its suitability and safety have not been assessed. The aim of the present study would be to assess the safety profile of topical application and/or local infiltrationof diluted epinephrine during EES regarding the intra- and postoperative periods. We hypothesize that epinephrine may be safely used during EES. METHODS Retrospective analysis of 90 EES cases performed at the University Hospital of Modena, Italy. Patient's charts and video recordings of the operations were assessed. RESULTS Epinephrine was used in all cases for hemostatic purposes as following: (1) diluted epinephrine (1:200,000) injection: mean 1.2 mL (range: 0-3.5) corresponding to 0.006 mg (range 0-0.018), and (2) topical application (1:1,000) directly in the surgical field: mean 7 cottonoids (range: 0-18) corresponding to mean 0.56 mg (range: 0-1.44). No major cardiovascular adverse effects were assessed. Only 2 intraoperative hypertensive events were recorded. One sensorineural hearing loss was observed in a case of cholesteatoma involving the stapes; no facial palsy occurred during the study period. CONCLUSION The combined use of local injection and topical epinephrine is a safe and effective strategy to control bleeding in exclusive EES, when used within the dilutions and quantities reported in this study.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Beckmann, Sven; Caversaccio, Marco and Anschütz, Lukas Peter


600 Technology > 610 Medicine & health








Stefan Weder

Date Deposited:

22 Jan 2020 11:05

Last Modified:

22 Jan 2020 11:05

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Bleeding Efficacy Endoscopic ear surgery Epinephrine Safety



Actions (login required)

Edit item Edit item
Provide Feedback